Age and outcome after aneurysmal subarachnoid haemorrhage

In 1941, Richardson and Hyland wrote that the prognosis of patients with ruptured aneurysms was worse with increasing age and if they had pre-existing hypertension.1 Loss of consciousness at ictus, prolonged coma and focal neurological deficits also portended worse outcome. Prognostic models derived three quarters of a century later confirm these findings, albiet more rigorously; Jaja and colleagues developed prediction models for outcome after aneurysmal subarachnoid haemorrhage (SAH) and found few additional variables improved outcome prediction beyond admission neurological grade, age and pre-existing hypertension.2 The relationship between patient age, clinical grade on admission and outcome after aneurysmal SAH is explored in detail by Ikawa, et al 3. The new finding is the relationship between age and poor outcome is not linear for patients admitted in World Federation of Neurological Surgeons (WFNS) grades 1–3, who are termed good-grade patients. There was a …